Will 'Health Care' Kill American Medicine?

My mother, a doctor's daughter who became a doctor herself, sometimes accompanied her father when he made house calls in the Livermore Valley of California during the Great Depression.

Her job was to open and close the gates at the ranches and farms they visited.

In those tenuous times, as she later recalled, her father occasionally provided his services without a fee or in return for whatever unsolicited payment-in-kind the rancher or farmer produced.

Medicare and Medicaid did not exist in those days. Nor were there massive for-profit insurance companies or hospital chains. But America had good doctors and good local hospitals.

My grandfather spent his life serving his neighbors. Medicine was not just his job, but his vocation. He did not live by one set of values in his professional life and another in his personal life. He had one life and one set of values. They were indivisible.

My mother met my father at medical school. She ended up having 11 children, and decided not to practice medicine but to be a stay-at-home mom -- with an M.D. That was her vocation. She, too, had one life and one set of values.

My father, like my mother and my grandfather, lived by an indivisible code. The same moral vision that guided his family life, guided his life as a doctor and a neighbor.

In the latter part of my father's career, two ominous trends began to emerge in American medicine: nationalization of control and normalization of intrinsically evil practices. The neighborly relationships that prevailed between Americans and the local doctors and health care facilities they turned to in times of need were gradually being replaced by ever-more remote corporate and government entities.

(In his new book, "Falling in Love With America Again," Heritage Foundation President Jim DeMint calls such institutions the "Bigs" -- whose "continued existence ... is no longer contingent upon its quality of service.")

In 1965, Congress enacted Medicaid and Medicare, putting government in control of health care for Americans below a certain income level and over a certain age. In 2010, Congress enacted the Affordable Care Act, compelling all Americans who do not qualify for Medicaid or Medicare to purchase health insurance -- while promising significant subsidies for the purchase of insurance to anyone earning less than 400 percent of the poverty level (currently $95,400 for a family of four).